I Am Perhaps Dying: The Medical Backstory of Spinal Tuberculosis Hidden in the Civil War Diary of LeRoy Wiley Gresham – Dennis A. Rasbach MD FACS (Author), Janet Elizabeth Croon (Editor)

leroyIn November, 2019, I had the opportunity to read “The War Outside My Window: The Civil War Diary of LeRoy Wiley Gresham 1860-1865” by author Janet E. Croon. The book is a collection of the diary entries made by LeRoy Wiley Gresham (1847-1868) during the American Civil War.  He lived in Macon, Georgia and was born into a slave-owning family committed to the Confederacy.  Before reading the book I had no idea who Gresham was.  But what I found after reading his diary, is that he was a bright young man whose intellect improves as the journal progresses.  However, I also noticed that throughout the book he is in poor health that does not improve but instead declines as the diary moves towards 1863 and beyond.  LeRoy did not know he was dying until nearly right before his passing.  His parents and older sibling Thomas, most likely knew how severe his condition was but kept it hidden from him probably with the thought that telling him would break the will he had left following the devastating injury in 1856 that resulted in his left leg being crushed by a falling chimney.   We know that tuberculosis is what eventually took his life but at the time, there was much about his condition that doctors did not know and were unable to treat. Dennis A. Rasbach, M.D., F.A.C.S., has taken a look at LeRoy’s medical history to understand how his condition progressed and the various treatments prescribed to him by his treating physicians.

Dr. Rasbach has concluded that Mycobacterium tuberculosis is what ultimately took Leroy’s life.  It is formally known as Pott’s Disease, name after the late English surgeon Percival Pott (1714-1788).  Today, tuberculosis is rarely heard of and a diagnosis y would raise eyebrows and result in reactions of shock and surprise.  But during the time in which LeRoy lived, tuberculosis was the world’s deadliest killer and a diagnosis such as the one received by LeRoy, almost always resulted in death.  Dr. Rasbach elaborates further with the following statement:

In the second half of the nineteenth century, tuberculosis was the deadliest disease in the world, accounting for one-third of all deaths. Even today, a quarter of the world’s population is infected with TB, and the disease remains one of the top ten causes of death, claiming 1.7 million lives annually, mostly in poor and underdeveloped countries.”

Throughout the diary, LeRoy utilizes a number of medications and remedies to combat his deteriorating condition.  Each are examined in detail to see why doctors resorted to those specific remedies and how they affected his daily condition.  Readers might express surprise at some of the things LeRoy was given to take, most notably significant servings of alcohol. Today, we would not even think of giving a teenage alcohol to treat a condition but in the 1800s, it was a widely accepted method of treatment.  Incredibly, some of the things LeRoy used are still used today. Dr. Rasbach mentions where and some readers might be surprised to see exactly where.

The second half of the book is a collection of journal entries related mainly to his health which he notes is declining rapidly.  The descriptions are graphic and I can only imagine how difficult it must have been for those around him to tend to him daily.  He often complains of his back, headaches, upset stomach and contracted legs making it impossible for him to even think of walking.  The pain is so bad that in one entry, he writes “saw off my leg”.  This young man lived in daily pain and sadly, his doctors and family were powerless to help as the medicines we have today did not exist at the time. For LeRoy, it was a slow and agonizing death.  But he gave us plenty of clues about his health and in hindsight, Dr. Rasbach has connected all of the dots, revealing the culprit behind LeRoy’s death at just eighteen years of age.

If you have read LeRoy’s journal and want to know more about the health condition that plagued him throughout the book, this is a must read.  And even if you have not read it but want to know more about the deadly history of tuberculosis, this book will be a valuable addition to any library.

ASIN: B07D7G7RJ8

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